Laporan Askep pada Ny. B dengan abses mamae/payudara sinistra

D_VJD@ D_VJ D@ LFRF^D LFRF ^DU UD]D@ D]D@ RDMD @y. N MF@ED@ DN_F_ ADADF _C@C_]^D MC ^VD@E @V_D C@MDJ > ^_VM RD@FANDJD@ _F@HRD]C ND@]VG

Mcsusu` V`tul Afaf`ujc ]ueds Lfghaphl Rrdltcl Lgc`cl  Lfnutujd` Mdsdr Ad`uscd CC

Mcsusu` Hgfj ; Yc`md Dstrc Rf Rfradtdsdrc

R254>244>2:2

LFAF@]F^CD@ LF_FJD]D@ ^FRVNGCL C@MH@F_CD RHGC]FL@CL LF_FJD]D@ SHESDLD^]D KV^V_D@ KV^V _D@ LFRF^D LFRF ^DU UD]D@ D]D@ >24?

GFAND^ RF@EF_DJD@ D_VJD@ LFRF^DUD]D@ RDMD @y. N MF@ED@ DN_F_ ADADF _C@C_]^D MC ^VD@E @V_D C@MDJ > ^_VM RD@FANDJD@ _F@HRD]C ND@]VG

Mcdkuld` u`tul mcsftukuc pdmd ; Jdrc

;

]d`eedg

;

]fapdt

;

Rfancanc`e Gdpd`ed`

_ulwd` _uah`h' _.Lfp

Rfancanc`e Rf`mcmcld`

_rc Drc`c U^' _LA' A.Lfp.

NDN C RF@MDJVGVD@

D. Mfic Mfic`c `csc sc Dnsfs dmdgdj sudtu pf`canu`d` `d`dj' ncdsd`yd tfrkdmc dlcndt sudtu c`iflsc ndltfrc. Kcld ndltfrc af`yusup lf mdgda kdrc`ed` yd`e sfjdt' adld dld` tfrkdmc c`iflsc. _fndecd` sfg adtc md` jd`our' af`c`eedgld` rh`eed yd`e  nfrcsc kdrc`ed` md` sfg!sfg s fg!sfg yd`e tfrc`iflsc. _fg!sfg mdrdj putcj yd`e afrupdld`  pfrtdjd`d` tunuj mdgda mdgd a afgdwd` c`iflsc' nfrefrdl lf mdgda rh`eed tfrsfnut md` sftfgdj af`fgd` ndltfrc' sfg mdrdj putcj dld` adtc. _fg mdrdj putcj c`cgdj yd`e af`ecsc rh`eed tfrsfnut. Dlcn Dlcndt dt pf`c pf`can anu` u`d` d` `d`d `d`dj j c`c' c`c' adld adld kdrc` kdrc`ed ed` ` mcsfl mcsflct ctdr` dr`yd yd dld` dld` tfrmhrh`e. Kdrc`ed` pdmd dljcr`yd tuanuj mc sflfgcgc`e dnsfs md` af`kdmc mc`m mc`mc` c`e e pfan pfandt dtds ds dnsf dnsfs. s. Jdg Jdg c`c c`c afru afrupd pdld ld` ` afld afld`c `csa saff tunu tunuj j u`tu u`tul  l  af`ofedj pf`yfndrd` c`iflsc gfncj gd`kut. Kcld sudtu dnsfs pfodj mcmdgda' adld adld c`ifls c`iflscc ncsd ncsd af`ydn af`ydndr dr mc mdgda mdgda tunuj tunuj adupu` adupu` mcndwdj mcndwdj pfrauldd` pfrauldd` lugct' tfred`tu`e pdmd ghldsc dnsfs. C`iflsc pdmd pdyumdrd ncdsd`yd mcsfndnld` hgfj ndltfrc yd`e uaua mctf mctfau auld ld` ` pdmd pdmd lugc lugctt `hra `hradg dg * stdpjyghohoous durfus#. durfus#. C`if C`ifls lscc tfrk tfrkdm dmcc ljusus`yd pdmd sddt cnu af`yusuc. Ndltfrc adsul lf tunuj afgdguc lugct yd`e rusdl' ncdsd`yd pdmd putc`e susu yd`e rusdl pdmd adsd dwdg af`yusuc. Drfd yd`e tfrc`iflsc dld` tfrcsc mf`ed` `d`dj.

N. Rfrdwdtd` Rfrdwdtd` md` pf`ehndtd` pf`ehndtd` dnsfs pdyumdrd pdyumdrd 4. Rfodjld` Rfodjld` ld`tu`e ld`tu`e RV_ RV_ mf`ed` mf`ed` c`scsc c`scsc rdmcdg rdmcdg mdrc tf`edj mccldt pc`eecr  pc`eecr  drfhgd sfkdkdr mf`ed` kdgd```yd multus gdltcifrus md` eu`dld` prc`scp stfrcgcsdsc' nfrscjld` RV_ jc`eed nf`dr !nf`dr nfrscj. >. Mcgdluld` Mcgdluld` pf`eh pf`ehaprfsd` aprfsd` jd`edt jd`edt pdmd pdyumd pdyumdrd rd sfgdad 46!>2 af`ct' = ldgc(jdrc ?. D`kurld` D`kurld` cnu u`tul u`tul tftdp af`efgu af`efgudrld` drld` D_C tfrutdad tfrutdad pdmd pdmd pdyumdrd pdyumdrd

yd`eadscj af`efgudrld` D_C af`ofedj tfrkdmc`yd nf`mu`ed`  pdyumdrd pdmd scsc pdyumdrd yd`e gdc`. =. Af`ed`kurl Af`ed`kurld` d` cnu u`tul u`tul cstcrdjdt cstcrdjdt yd`e yd`e oulup oulup ydctu ac`cadg ac`cadg 5 kda sfjdrc md`af`elh`suasc adld`d` mf`ed` phgd af`u adld`d` sfcand`e yd`e tfrmcrc mdrc; ldrnhjcmrdt' prhtfc`' gfadl' vctdac` adupu` ac`frdg. 6. D`kurld` D`kurld` cnu cnu u`tul u`tul af`kded af`kded lfnfrscj lfnfrscjd` d` mcrc tfrutdad tfrutdad mcmdfrdj mcmdfrdj sflctdr  sflctdr   pdyumdrdmd` ed`tc ndgutd` > ldgc sfjdrc 9. Af`edkd Af`edkdrld rld` ` pdmd pdmd cnu odrd odrd af`yus af`yusuc uc yd`e yd`e nf`dr nf`dr ; d. ]fl`cl fl`cl af`yu af`yusuc suc yd`e yd`e nf`d nf`drr.  n. Lhaprfs pdyumdrd mf`ed` dcr jd`edt md` dcr mc`ec` sfodrd  nfred`tcd`. o.

Afslcpu` Afslcpu` mdgda lfdmdd` lfdmdd` adstctcs' adstctcs' jdrus sfrc`e af`yusuc af`yusuc  ndyc`yd.

m. Augdcg Augdcgdj dj af`yus af`yusuc uc pdmd pdmd pdyumd pdyumdrd rd yd`e yd`e sfjdt. sfjdt. f. Jf`tcld` Jf`tcld` af`yu af`yusuc suc pdmd pdmd pdyumd pdyumdrd rd yd`e yd`e af`edgda af`edgdacc dnsfs' dnsfs' tftdpc tftdpc D_C jdrus tftdp mclfgudrld`. 5. Dpdncgd Dpdncgd dnsfs dnsfs nfrtdandj nfrtdandj pdrdj md` af`efgu af`efgudrld` drld` `d`dj' `d`dj' nfrcld` nfrcld` d`tcnchtco pfr pdrf`tfrdg :. V`tul V`tul af`eurd`ec af`eurd`ec `yfrc ncsd ncsd mcnfrcld` mcnfrcld` hndt pfrfmd pfrfmd `yfrc `yfrc *acsdg`y *acsdg`ydd doftdac`hpjf` dtdu cnuprhif`#. Lfmud hndt tfrsfnut dad` u`tul cnu af`yusuc md` ndyc`yd.

O. ]frdpc 4. Fvdludsc Fvdludsc dnsfs dnsfs mf`ed` mf`ed` odrd odrd mcgdluld mcgdluld` ` hpfrdsc hpfrdsc *c`scsc *c`scsc dnsfs# mdgda d`fstfsc uaua. _ftfgdj mcc`scsc' mcnfrcld` mrdc` u`tul af`edgcrld` scsd dnsfs yd`e ‚au`elc`– adscj tfrtc`eedg mdgda pdyumdrd. >. Dnsfs ( `d`dj `d`dj lfaumcd lfaumcd` ` mcpfrclsd mcpfrclsd u`tul u`tul lugtur lugtur rfscstf`s rfscstf`scc md`  pfafrclsdd` RD. RD. ?. Kcld dnsfs dnsfs mcpfrlc mcpfrlcrdld` rdld` adscj nd`ydl nd`ydl tfrtc`eedg tfrtc`eedg mdgda pdyumdrd' pdyumdrd' sfgdc` mcpdsd`e mrdc` kued mcgdluld` nfndt pdyumdrd mf`ed` fgdstco

 nd`mdef. _ftfgdj >= kda tc`mdld`' pdscf` lh`trhg lh`trhg lfandgc u`tul  af`eed`tc ldssd. Rdscf` mcnfrcld` hndt d`tcnchtcld md` hndt  pf`ejcgd`e rdsd sdlct.

NDN CC R^H_F_ LFRF^DUD]D@

]d`eedg pf`eldkcd`

; >5 Ku`c >24?

Rulug

; 42.46 UCN

]fapdt

; Ldadr 4N Nd`esdg @usd C`mdj > ^_VM Rd`fandjd` _f`hpdtc Nd`tug

Hgfj

; Yc`md Dstrc Rfradtdsdrc

_uanfr Mdtd

; Lgcf`' lfgudred lgcf`' odtdtd` afmcs md` lfpfrdwdtd`' tca lfsfjdtd` gdc`

Afthmf

; Udwd`odrd' hnsfrvdsc' pfafrclsdd` icscl md` stumc mhluaf`

C.

Rf`eldkcd`

D. Cmf` Cmf`tc tctd tdss 4. Rdscf`  @dad

; @y. @y. N

]fapdt( ]d`eedg Gdjcr

; Nd Nd`tug' >6!2: !2:!4353

Kf`cs Lfgdac`

; Rfrfapud`

Dedad

; Csgda

_tdtus Rfrldwc`d`

; Ldwc`

Rf`mcmcld`

; _AR

Rflfrkdd`

; Rf`kdjct

_ulu ( Lfnd`esdd`

; Kdwd ( C`mh`fscd

Dgdadt

; _cghl' _fghpd`thrh' Cahecrc

Mcde`hsd Afmcs

; Dnsfs adadf sc`cstrd

 @hahr OA

; 626>93

]d`eedg adsul ^_

; >6 Ku`c >24?

>. Lfgu Lfgudr dred ed ( Rf`d Rf`d`e `eeu eu`e `e Kdw Kdwdn dn

 @dad

; Np. _

Vaur

; ?: tdju`

Rf`mcmcld`

; _AR

Rflfrkdd`

; _wdstd

Dgdadt

; _cghl' _fghpd`thrh' Cahecrc

Junu`ed` mf`e f`ed` pdscf scf`

; _udac

N. ^cwd ^cwdydt ydt Lfsfj Lfsfjdt dtd` d` 4. Lfsf Lfsfjd jdtd td` ` pdsc pdscf` f` d. ^cwd ^cwdy ydt lfs lfsfj fjdt dtd` d` sfl sfldr drd` d`e e ; Rdmd td`eedg 3 Ku`c >24? pdscf` af`efguj pdmd pdyumdrd lcrc`yd tfrdsd pd`ds' nf`eldl md` sdlct mcsfrtdc mfada mc sfguruj tunuj tfrutdad pdmd sddt adgda jdrc. Rdmd td`eedg 4? Ku`c >24? pu` lfgudred pdscf` afautusld` u`tul afandwd @y. N lf sdgdj sdtu  ncmd` yd`e afanuld prdltcl lgc`cl mc mfsd`yd' pdscf` af`ydtdld` mcnfrcld` hndt cnuprhif` *hndt d`tcc`igdadsc# md` dahxcocggc` *hndt d`tc d`tcnc ncht htcl cl#' #' mfad mfada a sfap sfapdt dt sfan sfanuj uj tftd tftdpc pc lfaf lfafrd rdjd jd` ` pdmd pdmd  pdyumdrd lcrc`yd tcmdl sfanuj' adgdjd` sfadlc` nfsdr' nfrwdr`d jctda' lugct tfrlfgupds md` ndjld` pfodj md` af`efgudrld` `d`dj. Lfgudr Lfgudred ed pdscf` pdscf` pu` afandwd afandwd @y. @y. N lf ^_VM ^_VM Rd`fan Rd`fandjd djd` ` _f`hpdtc u`tul mcgdluld` tc`mdld` gfncj gd`kut' pdmd td`eedg >6 Ku`c >24?.  n. ^cwdydt lfsfjdtd` gdgu

;

Rdsc Rdscf` f` af`y af`ydt dtdl dld` d` tcmd tcmdl l dmd dmd rcwd rcwdyd ydtt pf`y pf`ydl dlct ct dsad dsad'' MA' MA' jcp jcpfrtf frtf` `sc

adup adupu` u`

dgfr dgfrec ec..

Rdscf dscf` `

af`yd f`ydtd tdl ld`

c`c c`c

dmdg dmdgdj dj

 pf`edgdad` pfrtdad`yd adsul lf ruadj sdlct u`tul af`kdgd`c  pfrdwdtd` md` pf`ehndtd`. Rdscf` af`ydtdld` mugu`yd pfr`dj clut LN su`tcl.

>. Lfsf Lfsfjd jdtd td` ` lfgu lfgudr dred ed d. Ef`herda

;

Lftfrd`ed` ;

; Gdlc!gdlc

; Rfrfapud`

; lgcf` yd`e sdlct

; Edrcs pfrldwc`d`

; Edrcs lfturu`d`

; ]c`eedg sfruadj

 n. ^cwdydt lfsfjdtd`

;

Rdscf` af`ydtdld` mugu dmcl`yd kued pfr`dj af`edgdac pf`ydlct

yd`e yd`e sdad sdad.. ]ftdp ftdpcc dmcl dmcl`y `ydd tcmd tcmdl l afaf afafrcl rclsdl sdld` d``y `ydd lf lgc` lgc`cl  cl  dtdup dtdupu` u` ruad ruadj j sdlct sdlct.. Dmcl Dmcl`y `ydd afrdw afrdwdt dt sf`mc sf`mcrc rc guld guld`y `ydd md` md` afac`u afac`ua a nfrnde nfrndedc dc hndt!hn hndt!hndtd` dtd`'' guld guld dmcl`y dmcl`ydd sfanuj sfanuj mf`ed` mf`ed` sf`mcrc`yd. Rdscf` af`ydtdld` ndjwd putc`e pdyumdrd acgcl`yd md` dmcl`yd sdad' ydctu adsul lf mdgda. Rdscf`

af`ydtdld`

cnu`yd md` `f`fl`yd tcmdl afacgclc rcwdydt putc`e yd`e adsul lf mdgda. Mcd`tdrd lfgudred pdscf` tcmdl dmd yd`e af`mfrctd pf`ydlct MA' jcpfrtf`sc' dsad adupu` dgfrec. O. Rhgd Rhgd Lfnc Lfncdsd dsdd` d` Rdsc Rdscf` f` 4. Dspf Dspfl l Icsc Icscl l Nchg Nchghe hecs cs d. Rhgd @utrcsc 4# _fnfgua sdlct ; Rdscf` adld` sfjdrc tced ldgc' sftcdp pdec' scd`e md` adgda jdrc. Rdscf` suld adld` nudj!nudjd` md` sdyurd`' sd yurd`' tcmdl suld adld` mdec`e dyda. Rdscf` kued tcmdl suld adld` adld`d` yd`e yd`e tfrgdgu tfrgdgu dsc` dsc` adupu` adupu` ad`cs' ad`cs' suld`y suld`ydd yd`e yd`e pds!pd pds!pdsd` sd` sdkd. Rdscf` ncdsd`yd ac`ua 6 efgds sfjdrc *´ 562 ag# ># _fgdad sdlct

;

Rdscf` adld` ?x sfjdrc sfsudc yd`e mcnfrcld` hgfj ruadj sdlct sdlct.. Mdgda Mdgda adld adld`' `' pdscf pdscf` ` tcmd tcmdl l af`e af`edg dgdac dac adsdg adsdgdj dj.. _fgdad sdlct' pdscf` ac`ua jd`yd ?22 aG sfjdrc' mf`ed` dgdsd` dgdsd` pdscf pdscf` ` adgd adgdss nhgd nhgdl! l!nd ndgc gcl l lf ldad ldadrr ad`mc ad`mc u`tu u`tul  l  lf`oc`e.  n. Rhgd Fgcac`dsc 4# _fnfgua sdlct ; Rdscf` ncdsd NDL 6x sfjdrc. V`tul NDN' pdscf` af`ydtdld`  ncdsd`yd > jdrc sfldgc. Lgcf` af`edlu tcmdl pfr`dj af`elh`suasc hndt!hndtd` pf`odjdr. ># _fgdad sdlct

;

Rdscf Rdscf` ` af`y af`ydt dtdl dld` d` NDL NDL sfjd sfjdrc rc ?x. ?x. Rdscf Rdscf` ` af`y af`ydtd dtdld ld` `  nfgua NDN sfkdl adsul ruadj sdlct' sumdj sfkdl ? jdrc yd`e yd`e

gdgu. o. Rhgd Rhgd dltcv dltcvct ctds ds cstc cstcrdj rdjdt dt ‟ tcmu tcmur  r  4# _fnfgua sdlct ; Lgcf` af`ydtdld` tcmdl pfr`dj hgdjrded sfgdad mc ruadj. Lgcf` tcmur mdgda sdtu jdrc ncdsd`yd 5 kda sfjdrc' ydctu mdrc  kda 44 adgda sdapdc kda 26.?2 pdec. Lgcf` af`ydtdld` tcmd tcmdl l pfr` pfr`dj dj tcmur tcmur scd`e scd`e.. Lgcf Lgcf` ` ncdsd ncdsd`y `ydd tcmu tcmurr

mf`e mf`ed` d`

af`eeu af`eeu`dl `dld` d` eugc`e eugc`e md` mdgda mdgda lfdmdd` lfdmdd` phscsc phscsc acrc`e acrc`e.. Lgcf` af`ydtdld` lfecdtd` sfjdrc!jdrc`yd jd`ydgdj nflfrkd' ydctu ydctu

af`k af`kdj djct ct ndk ndku u pfsd` pfsd`d` d` mdr mdrcc pfgd` pfgd`ee eed` d``y `yd. d.

># _fsumdj sdlct ; Lgcf` ncsd afgdluld` dltcictds sfjdrc!jdrc mf`ed` ad`mcrc. ]cmdl dmd lfgujd` ed`eeud` pfr`dpdsd`. Mc ruadj sdlct'  pdscf` af`efguj tcmdl ncsd tcmur' ldrf`d phscsc yd`e lurd`e dad` md` `ydad`' tfrutdad mc ruadj sdlct tcmdl mcsfmcdld` eugc`e

sfn sfndedc dedc

pfrgf`e f`eldpd`

tfapdt

tcmur.

Lgcf`

af`eu`eldpld` pfrdsdd`yd odpfl kued afrdsd nhsd` md`  kf`uj' ldrf`d lfecdtd``yd mc ruadj sdlct jd`ydgdj tcmurd` sdkd. m. Rhgd Rhgd lfn lfnfr frsc scjd jd` ` mcrc mcrc 4# Lfnf Lfnfrs rscj cjd` d` mcrc mcrc ; Rdsc Rdscf` f` ad`m ad`mcc jd`y jd`ydd pdmd pdmd pdec pdec sdkd sdkd'' md` md` jd`yd mcusdp mf`ed` ># ^danut  pdyumdrd`yd'

wdsgdp' tcmdl af`eeu`dld` sdnu`.

; _d _dtu jd jdrc sf sfnfgua af af`kdgd`c hp hpfrdsc pd pdmd pdscf` af`ydtdld` sfapdt lfrdads. ]cmdl 

dmd adsdgdj pdmd lugct rdanut md` ?# ]fgc`ed

rdanut pdscf`.

; ]c ]cmdl dmd adsdgdj md m d` ed e d`eeud` pdmd

tfgc`ed pdscf`. =# Adtd

; ]cmdl dmd adsdgdj md` ed`eeud` pdmd adtd

 pdscf` 6# Augut

; Rd Rdscf` af af`ydtdld` eh ehshl ec ecec sf sfjdrc mu mud

ldgc' ldgc' ndcl ndcl ctu mc ruadj ruadj adupu` adupu` sfgdad sfgdad mcrdwd mcrdwdtt mc ruadj ruadj

sdlct. 9# Lulu( ldlc

; Lulu ldlc md` td`ed` lgcf` tdapdl  

 pd`kd`e!pd`kd`e' tcmdl tfrmdpdt lhthrd`. f. Dspfl Dspfl Af`tdg Af`tdg ! C`tf C`tfgfl gfltud tudgg ‟ _hscdg _hscdg ‟ _pcr _pcrctu ctudg dg 4# Lh`s Lh`sfp fp mcrc crc Rfrd` lgcf` u`tul af`kdmc shshl cnu ndec d`dl!d`dl`yd tfred`eeu' dpdgdec d`dl`yd yd`e tfrlfocg adscj nfruaur = tdju`. Lgcf` tfrgcjdt tcmdl sdndr u`tul sfefrd pugd`e' sfjc`eed pflfrkdd`yd sfndedc pf`kdjct tcmdl tfrnf`eldgdc sfodrd nfrgdrut!gdrut. Rdscf` af`ydtdld` tdlut lfefauld`. ># C`tf C`tfgf gflt ltu udg Lgcf` af`eftdjuc ndjwd mc pdyumdrd`yd tfrkdmc c`iflsc' tftdpc tcmdl tdju pfrscs pf`yfndn`yd. _fgdad guld mc  pdyumdrd`yd pfodj md` af`efgudrld` `d`dj' pdscf` sftcdp jdrc sfgdgu rdkc` u`tul afanfrscjld` pdyumdrd`yd. ?# Junu Junu`e `ed` d` c`tfr c`tfrpf pfrsh rsh`d `dgg Junu`ed` lgcf` mf`ed` lfgudred ndcl' mctd`mdc mf`ed` sudac' d`dl ‟ d`dl md` cnu`yd yd`e mdtd`e u`tul  af`fad`c`yd mc ruadj sdlct. =# Afld Afld`c `csa saff lhpc lhpc`e `e Rdscf` tfrgcjdt tf`d`e mf`ed` pf`ydlct yd`e mcjdmdpc`yd' tftdpc pdscf` tfrgcjdt ofads afaclcrld` pflfrkdd``yd yd`e sfndedc sfhrd`e pf`kdjct tfrnf`eldgdc mc ruadj. Rdscf` sfapdt af`efguj ndjwd mc sdtu rud`ed` tcmdl dmd pdscf` yd`e gdc` sfjc`eed afrdsd lfsfpcd`. 6# Dspf Dspfl l af`t af`tdg dg ! fahs fahsch ch`d `dgg Lftcld mcgdluld` pf`eldkcd`' pdscf` af`frcad`yd mf`ed`  ndcl md` dtrdltci. Rdscf` tftdp afapfrtdjd`ld` lh`tdl adtd mf`ed` pf`eldkc' dpdncgd sudsd`d augdc sfpc md` tcmdl dmd yd`e nfrncodrd' pdscf` tfrgcjdt afadgc`eld` auld. Lfsfsudcd` difl tfrjdmdp sctudsc tcmdl dmd adsdgdj.

9# Dspf Dspfl l c`tfg c`tfgfe fef` f`sc sc Afahrc pdscf` adscj ndcl mctd`mdc mf`ed` dpdncgd mctd`yd tf`td`e rcwdydt pf`ehndtd` md` pfrdwdtd` yd`e pfr`dj mckdgd`c' pdscf` adscj af`ec`edt`yd.

M. Rfaf Rfafrcl rclsdd sdd` ` Icsc Icscl  l  4. Lfdm fdmdd` dd` ua uaua d.

Lfsdmdrd`

 n.

_tdtus Eczc

; Ohaphs Af`tcs

4# ]N ]N

; 466 oa

># NN

; 69 le

?# D`trhphaftrc

; >? >?'?

o.

]d`md ‟ td`md vctdg 4# ]fld` fld`d` d` mdrdj drdj ; 42 422(: 2(:2 aa aaJe ># _uju tunuj

; ?9'? ²O

?# @dmc

; 4>2 x(af`ct

=# Rfr`dpdsd`

; >= x(af`ct

>. Rfafrcl Rfafrclsdd` sdd` sfodr sfodrdd scstfac scstfacl l *ofpdgh *ofpdgh ‟ ldumd ldumdg# g# 4#

Lfpdgd

;

^danut wdr`d jctda md` tcmdl nfrodnd`e' tcmdl dmd lutu' tcmdl dmd lfthanf' tcmdl dmd gfsc' tcmdl dmd nf`khgd`' iu`esc  pf`mf`edrd` adscj ndcl' tcmdl dmd sforft yd`e lfgudr mdrc jcmu`e. >#

Gfjfr ; ]cmdl dmd nflds hpfrdsc' tcmdl dmd pfanfsdrd` lfgf`kdr  tcrhcm' tcmdl dmd pfanfsdrd` vf`d kueugdrcs' tcmdl dmd  pfanfsdrd` lfgf`kdr gcaif.

?#

Mdmd ; d# C`spflsc

;

]cmdl scaftrcs' tfrkdmc pfanf`eldld` pdmd pdyumdrd lcrc'  pdyumdrd lcrc nfrwdr`d afrdj md` tfrmdpdt pus. Lfmud

 putc`e pdyumdrd adsul lf mdgda' tcmdl dmd lfgdc`d`  pdmd sddt nfr`dids. Dmd `yfrc tfld`' `yfrc 6 u`tul  rf`td`e sldgd `yfrc mdrc 4!42. @yfrc jcgd`e tcanug  n# Rdgpdsc

;

Rdyumdrd afanf`eldl' mcsfrtdc dmd`yd `yfrc tfld` o# Rfrlusc

;

]cmdl tfrldkc m# Duslugtdsc ; Nu`yc kd`tu`e `hradg' pfr`dpdsd` tfrdtur  =#

Dnmhaf` ; d# C`spflsc

;

_caftrcs' tcmdl dmd nf`khgd` dtdupu` adssd' tcmdl dmd guld hpfrdsc' tcmdl dsoctfs  n# Rdgpdsc

;

]cmdl dmd `yfrc tfld`' tcmdl mctfauld` nf`khgd` o# Rfrlusc

;

 @hradg' tcmdl dmd ed`eeud`. _udrd tcapd`c m# Duslugtdsc ; Ncsc`e usus gfadj 6#

Flstrcactds ; d# Flst Flstrc rcac actd tdss dtds dtds ; _caftrcs' tcmdl dmd hfmfad' tcmdl dmd pf`ydlct lugct' lulu nfrscj tdpc pd`kd`e!pd`kd`e' tcmdl dmd ododt  n# Flstrcactds ndwdj ; _caftrcs' tcmdl dmd hfmfad' tcmdl dmd pf`ydlct lugct' lulu nfrscj tdpc pd`kd`e!pd`kd`e' tcmdl dmd ododt

CC. CC.

Rf`e Rf`ehn hndt dtd` d` Sd`e d`e Mcm Mcmdp dpdt dt _ddt _ddt C`c C`c D. C`ius C`ius ^G >2 tpa tpa pdmd td`ed` td`ed` ld`d` pdscf`' pdscf`' tfrpdsd`e tfrpdsd`e sfkdl sfkdl >6 Ku`c Ku`c >24? N. C`iu C`iuss M6& M6& >2 >2 tpa tpa

O. C`kflsc C`kflsc Ofitrc Ofitrcdxh dxh`f `f >x4erd >x4erda a pfrjdrc pfrjdrc M. C`kflsc C`kflsc ^dtd` ^dtd` >x62 >x62ae ae pfrjd pfrjdrc rc F. C`kflsc C`kflsc ]frd`hg frd`hg >x?ae >x?ae pfrj pfrjdrc drc I. C`kflsc C`kflsc Ldg`fx Ldg`fx >x>62a >x>62ae e pfrj pfrjdrc drc

CCC. CCC.

Rfafrcl Rfafrclsdd` sdd` Rf`u`k Rf`u`kd`e d`e Sd`e Rfr`dj Rfr`dj Mcgdlu Mcgdluld` ld` Nfsfrtd Nfsfrtd Jdscg` Jdscg`yd yd D. ^h`tef` ^h`tef` ; ]jhrdx ]jhrdx Rd Mfwdsd' Mfwdsd' mf`ed` mf`ed` jdscg pugah pugah tcmdl tdapdl  tdapdl  lfgdc`d`' nfsdr ohr `hradg *>6 Ku`c >24?# N. Rfafrclsdd` Rfafrclsdd` FLE' FLE' mf`ed` mf`ed` jdscg' `hradg `hradg sc`us sc`us rjytja rjytja *>2 Ku`c Ku`c >24?# O. Rfafrclsdd` Rfafrclsdd` Gdnhrdt Gdnhrdthrcua hrcua *>6 *>6 Ku`c >42?# >42?# mf`ed` mf`ed` jdscg jdscg ;

LHARH@F@

JD_CG

MD^DJ GF@ELDR H]HAD]C_ JN *Jfaheghnc`# 4?'3 DG *D`eld Gfulhsct# >='= DF *D`eld Frctrhsct# 6'26 D] *D`eld ]rhanhsct# ?3'? JA] *Jfadthlrct# ?3'> JC]V@E KF@C_ GFVLH_C] Fhsc`hicg 2 Ndshicg 2 Ndtd`e = _feaf` :: Gcaihsct 5 Ah`hsct 4 Ehgh`ed` Mdrdj N Egulhsf _fwdltu 3? Vrfua Mdrdj >9 Lrfdtc` Mdrdj 2':9 _EH] : _ER] 3  @dtrcua 4?:'9 Ldgcua ='4? Ojghrcmd 425': JN_DE Lud`tctdtci 72'42 `h` rfdltci

@CGDC @H^ADG

_D]VD@

E r& ^cnu(ug Kutd(ug ^cnu(ug &

4>!46 =!42 ='2!6'2 462!=62 ?9!=9

& & & & & & Ae(mg Ae(mg Ae(mg Ae(mg u(G u(G Aahg(g Aahg(g Aahg(g

>!= 2!4 >!6 64!95 >2!?6 =!: 7>22 45!=? 2'9!4'4 ?'6!6'6 ?!=6 2!?6 4?6!4=: ?'6!6'? 3:!425 74 `h` rfdltci   4!62 phsctci  gfadj 562 rfdltci 

D@DGC_D MD]D

Mdtd

Adsdgdj

MH ;

Ftchghec

 @yfrc Dlut

Rrhsfs pfrdmd`ed`

^fsclh C`iflsc

Lfrusdld` kdrc`ed`

4. ]d`md d`md!t !td` d`md md vctd vctdgg ; !@dmc

; 4>2 x(af`ct

!Rfr`dpdsd`; >= x(af`ct >. ]frmd frmdpd pdtt lfaf lfafrdj rdjd` d` md` md`  pfanfsdrd` pdmd pdyumdrd sfnfgdj lcrc pdscf` ?. Rdscf` Rdscf` sfrc`e sfrc`e af`eun af`eundj dj phscsc phscsc u`tul af`ejc`mdrc `yfrc =. Rdscf Rdscf` ` tfrg tfrgcj cjdt dt afr afrc` c`ec ecss af`djd` sdlct 6. Rdsc Rdscf` f` tfr tfrgc gcjd jdtt gfad gfadss M_ ; 4. Rdscf Rdscf` ` af`ydt af`ydtdl dld` d` `yfrc `yfrc pdm pdmdd  pdyumdrd sfnfgdj lcrc`yd >. Rdscf Rdscf` ` af`ydt af`ydtdl dld` d` sldg sldgdd `yfrc `yfrc 6 u`tul rf`td`e sldgd `yfrc 4! 42 ?. Rdscf Rdscf` ` af`y af`ydtd dtdld ld` ` tcmdl tcmdl ncsd ncsd tcmur ldrf`d afrdsdld` `yfrc =. Rdscf Rdscf` ` af` af`ydt ydtdl dld` d` `yfrc `yfrc jcgd`e tcanug MH ; 4. ]frpd frpdsd sd` `e C`iu C`iuss ^G >2 tpa tpa  pdmd td`ed` ld`d` pdscf` >. _ft _ft c`iu c`iuss tfrp tfrpds dsd` d`e e sfkd sfkdl l >6 Ku`c >24? ?. ]frmdpdt

pfrdmd`ed`'

md`

lfafrdjd` pdmd pdyumdrd lcrc  pdscf` =. Jdscg Jdscg pfaf pfafrcl rclsdd sdd` ` gdn gdn ; !DG *D`eld Gfulhsct# ; >='= ^cnu(ug !Gcaihsct ; 5& !_feaf` ; ::& M_ ; ! MH ;

Ed`eeud` ph phgd tc tcmur

4. Rdsc Rdscf` f` tfr tfrgc gcjd jdtt gfad gfadss >. Rf`uru`d`

phgd

tcmur

]cmdl id idacgc cgcfr mf mf`ed`  pfrdnht tcmur 

mdrc

sfjdr sfjdrcc 5 kda' kda' af`k af`kdm dmcc tcmd tcmdl  l   ncsd tcmur `yf`ydl  M_ ; 4. Rdsc Rdscf` f` af`y af`ydt dtdl dld` d` tcmu tcmur` r`y yd lurd`e' tcmdl sfpfrtc ncdsd`yd >. Rdsc Rdscf` f` af` af`efgu efguj j tcmd tcmdl l ncsd csd tcmur ldrf`d phscsc yd`e tcmdl  dad` md` `ydad` ?. Rdscf Rdscf` ` af`y af`ydt dtdld dld` ` tcmdl tcmdl ncsd ncsd tcmur `yf`ydl td`pd eugc`e MCDE@H_D LFRF^DUD]D@ MD@ R^CH^C]D_ AD_DGDJ

4. @yfrc dlut dlut nfrjun nfrjunu`ed` u`ed` mf`ed` mf`ed` prhsfs prhsfs pfrdmd`ed pfrdmd`ed` ` mctd`mdc mctd`mdc mf`ed` mf`ed` >. ^fsclh c`iflsc c`iflsc nfrjunu`e nfrjunu`ed` d` mf`ed` mf`ed` lfrusdld` lfrusdld` kdrc`ed` kdrc`ed` mctd`mdc mctd`mdc mf`ed` mf`ed` ?. Ed`eeud` Ed`eeud` phgd phgd tcmur nfrjun nfrjunu`ed u`ed` ` mf`ed` mf`ed` tcmdl idacgcfr idacgcfr mf`ed` mf`ed` pfrdnht pfrdnht tcmur mctd`mdc mf`ed`

RF^F@OD@DD@ LFRF^DUD]D@

MCDE@H_D ]VKVD@

RF^F@OD@DD@ ^F@OD@D

 @yfrc dlut

_ftfgdj mcgdluld`

]C@MDLD@ Hnsfrvdsc md` odtdt

 nfrjunu`ed`

tc`mdld`

lfgujd` ghldsc

mf`ed` prhsfs

lfpfrdwdt`

 nfrdt`yd *sldgd 2!42#

 pfrdmd`ed`

sfgdad =x>= kda

md` fifl yd`e

mctd`mdc mf`ed`

`yfrc pdscf`

mctcanugld` hgfj

af`kdmc

`yfrc

 nfrlurd`e mf`ed`

^dsch`dg ; Afand`tu

lrctfrcd jdscg ;

afanfmdld`

4. Adapu

 pf`yfndn `yfrc md`

LFRF^DUD]D@

af`eeu`dld`

afanfrcld`

tfl`cl 

c`ihradsc tf`td`e

`h`idradlhgh

lfadkud` dtdu

ec u`tul 

 pfrndcld` pf`ydlct'

af`eurd`ec

tfrkdmc`ydd

`yfrc

lhapgcldsc md`

>. Af`ydtdld`

lffifltcid` c`tfrvf`sc.

rdsd `ydad`

µ

sftfgdj `yfrc

td`md vctdg

 nfrlurd`e

^dsch`dg ;

?. ]d`m d`md vctd vctdgg

Rd`tdu td`md!

Rf`c`eldtd` `yfrc

mdgda ndtds

dld` af`c`eldtld`

`hradg ;

td`md!td`md vctdg

! @dmc ; 32

µ

x(af`ct

af`eeu`dld` tfl`cl 

!^^ ; 43

rfgdlsdsc md` `dids

x(af`ct

mdgda dtdu tfl`cl 

=. ]cmdl  

Dkdrld` u`tul 

mcstrdlsc sfpfrtc

^D_CH@DG

af`edgdac

af`mf`edrld` auscl 

ed`eeud`

dtdu afandod nulu

tcmur 

^dsch`dg ; Afand`tu dtdu af`eh`trhg af`edgcjld` rdsd `yfrc' afausdtld` lfandgc pfrjdtcd` md` mdpdt af`c`eldtld` lhpc`e µ Lhgdnhrdsc;Rfanfrcd` hndt d`dgeftcl sfsudc c`mcldsc ^dsch`dg ;

^fsclh c`iflsc

_ftfgdj mcgdluld`

Af`uru`ld` `yfrc. 4. Rd`tdu pfadsd`ed`

 nfrjunu`ed`

tc`mdld`

c`ius md` gdluld`

tfrkdmc`yd

mf`ed` lfrusdld`

lfpfrdwdtd`

mrfssc`e c`ius sfsudc

c`iflsc pdmd

 kdrc`ed` mctd`mdc

sfgdad 5x>= kda

 prhsfmur 

 pfadsd`ed`

mf`ed`

 pdscf` tcmdl 

4. Af`ofedj

c`ius.

af`edgdac c`iflsc mf`ed` lrctfrcd jdscg ;

Ouoc td`ed` sftcdp

Af`eurd`ec

4. Lgcf` nfnd fnds

sfnfgua md` sfsumdj

md` af`ofedj

tc`mdld` lfpfrdwdtd`

lh`tdac`dsc

mdrc td`md md` efkdgd c`iflsc

scgd`e d`tdrd

>. Kuagdj

 pfrdwdt mf`ed`

 pfafrclsdd`

 pdscf`

gdn mdgda rf`td`e

Dwdsc td`md ‟ td`md

Mfada mf`ed`

`hradg

vctdg

 pf`c`eldtd`

DG *D`eld

`dmc md`

Gfulhsct# =!

 pfr`dpdsd`

42

dmdgdj td`md

^cnu(ug

 pf`c`eldtd`

_feaf` 64!95

gdku aftdnhgco

&

mdrc prhsfs

Gcaihsct >2!

c`igdadsc'

?6

afslcpu`

&

sfpscs mdpdt

?. Af` Af`u`ku u`kul lld` ld`

tfrkdmc td`pd

lfadapud`

rfsph` mfada

u`tul  af`ofedj

Dkdrld` pdscf` md`

Rdscf` md`

tcanug`yd

lfgudred td`md md`

lfgudred

c`iflsc

efkdgd kued odrd

af`efrtc

 pf`ofedjd` c`iflsc

tf`td`e c`iflsc sfjc`eed ncsd af`ofedj`yd

. Lfghgd pfanfrcd`

. D`tcnchtcl 

d`tcnchtcl c`kflsc

mdpdt af`ofedj

ofitrcdxh`f >x4 ae

dtdu afanu`uj  ndltfrc  pf`yfndn c`iflsc adsul  lf tunuj

. Ed`eeud` phgd

_ftfgdj mcgdluld`

!

tcmur nfrjunu`ed`

tc`mdld`

fifl!fifl afmcldsc

mf`ed` tcmdl 

lfpfrdwdtd`

tfrjdmdp phgd tcmur 

idacgcfr mf`ed`

sfgdad 4x>= kda

!

 pfrdnht tcmur 

ed`eeud` phgd

 pf`tc`e`yd tcmur yd`e

mctd`mdc mf`ed`

tcmur pdscf`

dmfludt

tfrdtdsc mf`ed`

!

lrctfrcd jdscg;

u`tul 

4. Kuagdj kd kda

afapfrtdjd`ld`

tcmur mdgda

dltcvctds sfnfgua

 ndtds `hradg

tcmur *afandod#

>. Adapu

!

Mftfrac`dsc

Kfgdsld`

Idscgctdsc

Ocptdld`

af`ecmf`tcicl  gc`elu`ed` yd`e dsc jdg!jdg

`ydad`

yd`e

!

Lhgdnurdsc

af`c`eldtld`  pfanfrcd` hndt tcmur  tcmur 

 ndtdsc dsupd` odcrd`  pdmd adgda jdrc md` d`kurld` nfrlfacj sfnfgua tcmur. µ

ndtdsc wdltu

tcmur scd`e.